Provider Demographics
NPI:1801378153
Name:AUSTIN, JASMINE (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BULLDOG BLVD
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-1899
Mailing Address - Country:US
Mailing Address - Phone:575-746-3585
Mailing Address - Fax:
Practice Address - Street 1:301 BULLDOG BLVD
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-1899
Practice Address - Country:US
Practice Address - Phone:575-746-3585
Practice Address - Fax:575-746-6232
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSLPA66292355S0801X
NMSAH-2024-0040235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant